Trazodone
- Atc Codes:N06AX05
- CAS Codes:25332-39-2#19794-93-5
- PHARMGKB ID:25332-39-2#19794-93-5
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Induces
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Trittico; Belgium: Nestrolan, Trazodone, Trazolan; Bulgaria: Trittico; Czech Republic: Trittico; Finland: Azona; Germany: Thombran, Trazodon; Greece: Trittico; Hungary: Trittico; Ireland: Molipaxin; Italy: Trittico; Lithuania: Trittico; Luxembourg: Trazodone, Trazolan; Netherlands: Trazolan; Poland: Trittico; Portugal: Trazodona, Trazone, Triticum; Romania: Trittico; Slovakia: Trittico; Slovenia: Trittico; Spain: Deprax; UK: Molipaxin, Trazodone.
North America
Canada: Desyrel (d), Trazodone, Trazorel; USA: Oleptro, Trazodone.
Latin America
Argentina: Taxagon AD; Brazil: Donaren; Mexico: Sideril.
Asia
Japan: Desyrel (d), Reslin, Undepre.
Drug combinations
Chemistry
Trazodone Hydrochloride: C19H22ClN5O.HCl. Mw: 408.32. (1) 1,2,4-Triazolo[4,3-a]pyridin-3(2H)-one, 2-[3-[4-(3-chlorophenyl)-1-piperazinyl]propyl]-, monohydrochloride; (2) 2-[3-[4-(m-Chlorophenyl)-1-piperazinyl]propyl]-s-triazolo[4,3-a]pyridin-3(2H)-one monohydrochloride. CAS-25332-39-2; CAS-19794-93-5 (trazodone)(1970).
Pharmacologic Category
Antidepressants; Serotonin Modulators. (ATC-Code: N06AX05).
Mechanism of action
Inhibits reuptake of serotonin, causes adrenoreceptor subsensitivity, and induces significant changes in 5-HT presynaptic receptor adrenoreceptors. Also significantly blocks histamine (H~1~) and α~1~-adrenergic receptors.
Therapeutic use
Treatment of depression.
Pregnancy and lactiation implications
When taken during pregnancy, increased risk of major malformations not observed in small number of pregnancies studied. Long-term effects on neurobehavior not evaluated. Enters breast milk (use with caution in nursing women).
Unlabeled use
Potential augmenting agent for antidepressants, hypnotic.
Contraindications
Hypersensitivity to trazodone or any component of the formulation.
Warnings and precautions
The possibility of a suicide attempt is inherent in major depression and may persist until remission occurs (use caution in high-risk patients during initiation of therapy). Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults (18-24 years of age) with major depressive disorder and other psychiatric disorders. Trazodone not FDA approved for use in children. May worsen psychosis in some patients or precipitate shift to mania or hypomania in bipolar disorder. Monotherapy in bipolar disorder should be avoided. Trazodone not FDA approved for treatment of bipolar depression. May cause orthostatic hypotension (use with caution in risk of this effect or in patients who would not tolerate transient hypotensive episodes). Use with caution in history of cardiovascular disease. Not recommended for use in a patient during acute recovery phase of MI. May cause sedation (degree of sedation very high relative to other antidepressants). Priapism, including cases resulting in permanent dysfunction, occurred with use of trazodone. Use with caution in hepatic impairment. Trazodone should be initiated with caution in patients receiving concurrent or recent therapy with a MAOI. Use with caution in renal impairment, and in risk of seizures, including patients with history of seizures, head trauma, brain damage, alcoholism, or concurrent therapy with medications which may lower seizure threshold. Effects may be potentiated when used with other sedative drugs or ethanol. Therapy should not be abruptly discontinued in patients receiving high doses for prolonged periods. May increase risks associated with electroconvulsive therapy.